Subcutaneous connective tissue response to primary root canal filling materials.

This study evaluated the response of the subcutaneous connective tissue of BALB/c mice to root filling materials indicated for primary teeth: zinc oxide/eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO) and Sealapex sealer. The mice (n=102) received polyethylene tube implants with the materials, thereby forming 11 groups, as follows: I, II, III: Calen/ZO for 7, 21 and 63 days, respectively; IV, V, VI: Sealapex for 7, 21 and 63 days, respectively; VII, VIII, IX: ZOE for 7, 21 and 63 days, respectively; X and XI: empty tube for 7 and 21 days, respectively. The biopsied tissues were submitted to histological analysis (descriptive analysis and semi-quantitative analysis using a scoring system for collagen fiber formation, tissue thickness and inflammatory infiltrate). A quantitative analysis was performed by measuring the area and thickness of the granulomatous reactionary tissue (GRT). Data were analyzed by Kruskal-Wallis, ANOVA and Tukey's post-hoc tests (?=0.05). There was no significant difference (p>0.05) among the materials with respect to collagen fiber formation or GRT thickness. However, Calen/ZO produced the least severe inflammatory infiltrate (p<0.05). The area of the GRT was significantly smaller (p<0.05) for Calen/ZO and Sealapex. In conclusion, Calen/ZO presented the best tissue reaction, followed by Sealapex and ZOE.

Changes in the profile of dental procedures performed in a pediatric clinic between 1980 and 2004

The goal of this research was to assess whether there was a change in the profile of dental procedures performed in the Pediatric Dental Clinic at the School of Dentistry of Ribeirão Preto at University of São Paulo during the period between the years 1980 to 2004. Using the dental records of 3,484 pediatric patients attended at the Pediatric Dental Clinic, we conducted a survey of clinical procedures performed by undergraduate students in the years 1980, 1984, 1988, 1992, 1996, 2000 and 2004. The following procedures, performed in deciduous and permanent teeth in children from 1 to 12 years, were: topicalapplications of fluoride, pit and fissure sealant applications, silver amalgam and composite resin fillings, pulpotomy and tooth extraction. The numeric values obtained for each procedure were converted into percentages, and data were analyzed using Fisher Exact or qui-square tests (α = 0.05). The results revealed the occurrence of a significant increase (p < 0.01) in percentage of topical fluoride applications (increase of 18.9%) and sealants applications (increase of 11.2%). On the other hand, the percentage of performance of silver amalgam and composite resin fillings, pulpotomies and tooth extraction showed a significant decline of 16.0, 6.0 and 16.1%, respectively (p < 0.05). It can be concluded that there was a decline of restorative, surgical and conservative endodontic procedures, with a concomitant increase of preventive procedures.

Variation of dentin dysplasia type I: report of atypical findings in the permanent dentition.

Dentin dysplasia is a rare defect of dentin development with an autosomal dominant pattern of inheritance, which is generally divided into 2 main classes based on the clinical and radiographic appearance of the affected dental tissues: type I, which affects the root portion and type II, which affects the coronal portion of the tooth. This paper reports the case of a child aged 10 years and 8 months with both classic and atypical features of dentin dysplasia type I in the permanent dentition. Only few mandibular teeth were affected and presented clinically normal appearing crowns, moderate to severe mobility, short, blunt or almost absent roots. However, no evidence of pulp chamber obliteration or periapical radiolucencies was found. The clinical and radiographic characteristics observed in this patient are different from those reported in the literature, which suggests that this may be a variation of dentin dysplasia type I expression.

Utilização do ionômero de vidro em odontopediatria / Glass ionomer cement in pediatric dentistry

O cimento de ionômero de vidro atualmente é considerado o material de escolha para uma variedadede procedimentos clínicos em Odontopediatria. Sua utilização é interessante devido às suas propriedades satisfatórias, dentre elas, a adesão aos tecidos mineralizados, a biocompatibilidade, o coeficiente deexpansão térmica semelhante ao dente e, principalmente, a liberação de flúor. O objetivo deste trabalhoé o de descrever as principais indicações do cimento de ionômero de vidro na prática odontopediátrica,destacando-se, dentre elas, seu uso para selamento de cavidades durante a etapa de adequação domeio bucal, o tratamento restaurador atraumático, como selante de fossas e fissuras, como base de restaurações,como material restaurador, na técnica do amálgama aderido e para cimentação de coroas de aço cromado e mantenedores de espaços fixos.

Actually the glass ionomer cement is the chosen material in many clinical procedures made in pediatricdentistry. It presents satisfactory properties like adhesion to dental surfaces, biocompatibility, thermal expansioncoefficient near to dental structure and the release of fluoride. The aim of this work is to describethe most relevant indications of glass ionomer cement on pediatric dentistry practice, like provisory restorations,atraumatic restorative treatment, pit and fissures sealants, liner, as definitive restorative material,on amalgam bond technique and cementation of stainless steal crown and fixed space maintainers

Subcutaneous connective tissue response to primary root canal filling materials

This study evaluated the response of the subcutaneous connective tissue of BALB/c mice to root filling materials indicated for primary teeth: zinc oxide/eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO) and Sealapex sealer. The mice (n=102) received polyethylene tube implants with the materials, thereby forming 11 groups, as follows: I, II, III: Calen/ZO for 7, 21 and 63 days, respectively; IV, V, VI: Sealapex for 7, 21 and 63 days, respectively; VII, VIII, IX: ZOE for 7, 21 and 63 days, respectively; X and XI: empty tube for 7 and 21 days, respectively. The biopsied tissues were submitted to histological analysis (descriptive analysis and semi-quantitative analysis using a scoring system for collagen fiber formation, tissue thickness and inflammatory infiltrate). A quantitative analysis was performed by measuring the area and thickness of the granulomatous reactionary tissue (GRT). Data were analyzed by Kruskal-Wallis, ANOVA and Tukey's post-hoc tests (?=0.05). There was no significant difference (p>0.05) among the materials with respect to collagen fiber formation or GRT thickness. However, Calen/ZO produced the least severe inflammatory infiltrate (p<0.05). The area of the GRT was significantly smaller (p<0.05) for Calen/ZO and Sealapex. In conclusion, Calen/ZO presented the best tissue reaction, followed by Sealapex and ZOE.

Neste estudo avaliou-se a resposta do tecido conjuntivo subcutâneo de camundongos BALB/c a materiais obturadores de canal radicular de dentes decíduos: óxido de zinco/eugenol (OZE), pasta Calen® espessada com óxido de zinco (Calen/OZ) e cimento Sealapex®. Os camundongos (n=102) receberam implantes de tubos de polietileno??? e foram divididos em grupos: I, II, III - Calen/OZ (7, 21 e 63 dias, respectivamente); IV, V, VI - Sealapex (7, 21 e 63 dias, respectivamente); VII, VIII, IX - OZE (7, 21 e 63 dias, respectivamente); X, XI - tubo vazio (7 e 21 dias, respectivamente). Os tecidos foram submetidos ao processamento e análise histopatológica descritiva e por meio de escores do fibrosamento, espessura tecidual e infiltrado inflamatório. Para a análise quantitativa mensurou-se a área e a espessura do tecido granulomatoso reacional (TGR). Os resultados foram analisados pelos testes de Kruskal-Wallis, ANOVA e pós-teste de Tukey (?=0,05). Não houve diferença significante (p>0,05) entre os materiais, com relação ao fibrosamento e à espessura do TGR. Contudo, Calen/OZ apresentou infiltrado inflamatório de menor intensidade (p<0,05). A área do TGR foi menor (p<0,05) para Calen/OZ e Sealapex. Pôde-se concluir que Calen/OZ foi o material que apresentou a melhor compatibilidade tecidual, seguido pelos cimentos Sealapex e OZE.

Variation of dentin dysplasia type I: report of atypical findings in the permanent dentition

Dentin dysplasia is a rare defect of dentin development with an autosomal dominant pattern of inheritance, which is generally divided into 2 main classes based on the clinical and radiographic appearance of the affected dental tissues: type I, which affects the root portion and type II, which affects the coronal portion of the tooth. This paper reports the case of a child aged 10 years and 8 months with both classic and atypical features of dentin dysplasia type I in the permanent dentition. Only few mandibular teeth were affected and presented clinically normal appearing crowns, moderate to severe mobility, short, blunt or almost absent roots. However, no evidence of pulp chamber obliteration or periapical radiolucencies was found. The clinical and radiographic characteristics observed in this patient are different from those reported in the literature, which suggests that this may be a variation of dentin dysplasia type I expression.

A displasia dentinária é uma alteração do desenvolvimento da dentina rara, de origem autossômica dominante, o qual é geralmente dividida em 2 tipos principais baseados na aparência clínica e radiográfica dos tecidos dentais afetados: tipo I, que afeta a porção radicular e o tipo II, que afeta a porção coronária do dente. O objetivo deste trabalho é relatar o caso de um paciente de 10 anos e 8 meses de idade com ambas alterações clássicas e atípicas da displasia dentinária do tipo I na dentição permanente. Alguns dentes da arcada inferior foram acometidos, apresentando-se com coroas clinicamente normais, mobilidade dental de moderada a severa e raízes curtas ou ausentes, porém sem evidência de obliteração das câmaras pulpares e de lesões periapicais. As características clínicas e radiográficas observadas neste paciente foram diferentes daquelas relatadas na literatura, o que sugere que esta possa ser uma variação da expressão da displasia dentinária do tipo I.

Seria o hábito de sucção de chupeta capaz de reduzir a síndrome da morte súbita em lactente / Is pacifier use related to the reduction of the sudden infant death syndrome?

Objetivos: Realizar uma breve revisão da literatura a respeito da síndrome da morte súbita em lactentes (SMSL) e a possível redução da mesma pelo uso da chupeta, a fim de chamar a atenção dos profissionais da saúde que prestam atendimento a crianças para o desenvolvimento de trabalhos de pesquisa nesta área. Fontes pesquisadas: Livre escolha de artigos pertinentes da literatura relacionados à SMSL e uso da chupeta. Síntese dos dados: Após revisão da literatura, os autores concluem que a maioria dos artigos existentes verifica que o uso da chupeta está relacionado à redução da SMSL, embora o exato mecanismo para que ocorra esta redução não seja conhecido. Discorrem, ainda, sobre outras maneiras de reduzir-se a SMSL, os potenciais riscos e benefícios do uso da chupeta, e fornecem orientações aos pais e profissionais com respeito à maneira mais correta de sua utilização. Conclusão: O uso da chupeta por lactentes está associado à redução no risco da síndrome da morte súbita, embora a recomendação aos pais quanto ao uso ou não da chupeta ainda seja um assunto controverso...

Objectives: To carry out a brief review of the literature about the possible reduction of the sudden infant death syndrome (SIDS) due to pacifier use in order to call the attention of health professionals assisting children to the development of researches in this field. Researched sources: Free choice of pertinent literature articles related to SIDS and pacifier use. Data synthesis: The majority of research papers published indicates that the pacifier use is related to the reduction of the occurence of the SIDS, although the mechanism involved is not clear. Other alternative approaches to avoid SIDS are discussed as well as the potential risks and benefits of pacifier use including information to the parents with regards to the proper way of use. Conclusion: The use of pacifiers by infants is associated to the reduction of the risk of sudden infant death syndrome, however the recommendation to the parents with regards to pacifier’s use is a controversial subject...

Impacto da adoção de medidas preventivas direcionadas a mães altamente infectadas sobre a saúde bucal do bebê / Impact of preventive mesarures directed to highly infected mothers on their children's oral health

Objetivos: Realizar uma breve revisão da literatura a respeito dos fatores relacionados à transmissibilidade da cárie dental e o impacto da adoção de medidas preventivas por mães altamente infectadas, sobre a colonização da cavidade bucal de seus filhos por microrganismos cariogênicos. Fontes pesquisadas: Livre escolha de artigos pertinentes da literatura relacionados à microbiota e à transmissibilidade da cárie dental. Síntese dos dados: As vias de transmissibilidade de Streptococcus mutans, os principais microrganismos causadores da cárie dental, são extensivamente estudadas e as mães são consideradas as principais responsáveis pela transmissão de microrganismos cariogênicos aos seus filhos. A possibilidade de interromper essa cadeia de transmissão de microrganismos por meio da utilização de medidas preventivas direcionadas às mães é um avanço na prevenção à cárie dental...

Objectives: To carry out a brief literature review regarding the factors related to the transmissibility of dental caries and the impact of the adoption of preventive measures directed to mothers highly infected on their children mouth contamination by cariogenic microorganisms. Data Source: Free choice of pertinent literature articles regarding to dental caries-related microorganisms and disease trans-mission. Data Synthesis: Transmissibility of Streptococcus mutans, the most important caries initiator microorganism, is extensively studied and mothers are considered the main responsible for cariogenic bacteria transmission to their children. The possibility of interrupting this chain of caries-related microorganism transmission by means of preventive measures directed to mothers is an advance in dental caries prevention...

Subcutaneous tissue response of isogenic mice to calcium hydroxide-based pastes with chlorhexidine.

This study was evaluated the response of subcutaneous connective tissue of isogenic mice to calcium hydroxide-based pastes with chlorhexidine digluconate (CHX). Seventy isogenic male BALB/c mice aged 6-8 weeks and weighing 15-20 g were randomly assigned to 8 groups. The animals received polyethylene tube implants as follows: Groups I, II, and III (n=10) - Calen paste mixed with 0.4% CHX (experimental paste; Calen/CHX) for 7, 21, and 63 days, respectively; Groups IV, V, and VI (n=10) - UltraCal paste mixed with 2% CHX (experimental paste supplied by Ultradent Products Inc.; Ultracal/CHX) for 7, 21, and 63 days, respectively; and Groups VII and VIII (n=5): empty tube for 7 and 21 days, respectively. At the end of the experimental periods, the implants were removed together with the surrounding tissues (skin and subcutaneous connective tissue). The biopsied tissues were subjected to routine processing for histological analysis. Using a descriptive analysis and a four-point (0-3) scoring system, the following criteria were considered for qualitative and quantitative analysis of the tissue around the implanted materials: collagen fiber formation, tissue thickness and inflammatory infiltrate. A quantitative analysis was performed by measuring the thickness (microm), area (microm(2)) and perimeter (microm) of the reactionary granulomatous tissue formed at the tube ends. Data were analyzed statistically by the Kruskal-Wallis test and Dunn's post-test (alpha=0.05). Calen/CHX showed biocompatibility with the subcutaneous and reactionary tissues, with areas of discrete fibrosis and normal conjunctive fibrous tissue, though without statistically significant difference (p>0.05) from the control groups. In Groups I to III, there was a predominance of score 1, while in Groups IV to VI scores 2 and 3 predominated for all analyzed parameters. UltraCal/CHX, on the other hand, induced the formation of an inflammatory infiltrate and abundant exudate, suggesting a persistent residual aggression from the material, even 63 days after implant placement. In conclusion, the Calen paste mixed with 0.4% CHX allowed an adequate tissue response, whereas the UltraCal paste mixed with 2% CHX showed unsatisfactory results.

Antibacterial activity of root canal filling materials for primary teeth: zinc oxide and eugenol cement, Calen paste thickened with zinc oxide, Sealapex and EndoREZ.

This study evaluated in vitro the antibacterial activity of 4 root canal filling materials for primary teeth - zinc oxide and eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO), Sealapex sealer and EndoREZ sealer - against 5 bacterial strains commonly found in endodontic infections (Kocuria rhizophila, Enterococcus faecalis, Streptococcus mutans, Escherichia coli and Staphylococcus aureus) using the agar diffusion test (agar-well technique). Calen paste, 1% chlorhexidine digluconate (CHX) and distilled water served as controls. Seven wells per dish were made at equidistant points and immediately filled with the test and control materials. After incubation of the plates at 37 degrees C for 24 h, the diameter of the zones of bacterial growth inhibition produced around the wells was measured (in mm) with a digital caliper under reflected light. Data were analyzed statistically by analysis of variance and Tukey's post-hoc test (alpha=0.05). There were statistically significant differences (p<0.0001) among the zones of bacterial growth inhibition produced by the different materials against all target microorganisms. K. rhizophila was inhibited more effectively (p<0.05) by ZOE, while Calen/ZO had its highest antibacterial activity against E. faecalis (p<0.05). S. mutans was inhibited by Calen/ZO, Sealapex and ZOE in the same intensity (p>0.05). E. coli was inhibited more effectively (p<0.05) by ZOE, followed by Calen/ZO and Sealapex. Calen/ZO and ZOE were equally effective (p>0.05) against S. aureus, while Sealapex had the lowest antibacterial efficacy (p<0.05) against this microorganism. EndoREZ presented antibacterial activity only against K. rhizophila and S. aureus. The Calen paste and Calen/ZO produced larger zones of inhibition than 1% CHX when the marker microorganism was E faecalis. In conclusion, the in vitro antibacterial activity of the 4 root canal filling materials for primary teeth against bacterial strains commonly found in endodontic infections can be presented in a decreasing order of efficacy as follows: ZOE>Calen/ZO>Sealapex>EndoREZ.

Subcutaneous tissue response of isogenic mice to calcium hydroxide-based pastes with chlorhexidine

This study was evaluated the response of subcutaneous connective tissue of isogenic mice to calcium hydroxide-based pastes with chlorhexidine digluconate (CHX). Seventy isogenic male BALB/c mice aged 6-8 weeks and weighing 15-20 g were randomly assigned to 8 groups. The animals received polyethylene tube implants as follows: Groups I, II, and III (n=10) - Calen® paste mixed with 0.4 percent CHX (experimental paste; Calen/CHX) for 7, 21, and 63 days, respectively; Groups IV, V, and VI (n=10) - UltraCal™ paste mixed with 2 percent CHX (experimental paste supplied by Ultradent Products Inc.; Ultracal/CHX) for 7, 21, and 63 days, respectively; and Groups VII and VIII (n=5): empty tube for 7 and 21 days, respectively. At the end of the experimental periods, the implants were removed together with the surrounding tissues (skin and subcutaneous connective tissue). The biopsied tissues were subjected to routine processing for histological analysis. Using a descriptive analysis and a four-point (0-3) scoring system, the following criteria were considered for qualitative and quantitative analysis of the tissue around the implanted materials: collagen fiber formation, tissue thickness and inflammatory infiltrate. A quantitative analysis was performed by measuring the thickness (µm), area (µm²) and perimeter (µm) of the reactionary granulomatous tissue formed at the tube ends. Data were analyzed statistically by the Kruskal-Wallis test and Dunn's post-test (á=0.05). Calen/CHX showed biocompatibility with the subcutaneous and reactionary tissues, with areas of discrete fibrosis and normal conjunctive fibrous tissue, though without statistically significant difference (p>0.05) from the control groups. In Groups I to III, there was a predominance of score 1, while in Groups IV to VI scores 2 and 3 predominated for all analyzed parameters. UltraCal/CHX, on the other hand, induced the formation of an inflammatory infiltrate and abundant exudate, ...

O objetivo do presente estudo foi avaliar a resposta do tecido conjuntivo subcutâneo de camundongos isogênicos frente a pastas à base de hidróxido de cálcio, associadas ao digluconato de clorexidina (CHX). Setenta camundongos isogênicos BALB/c machos, com 6-8 semanas e pesando 15-20 g foram aleatoriamente divididos em 8 grupos. Os animais receberam implantes de tubos de polietileno contendo: Grupos I, II e III (n=10) - pasta Calen® associada à CHX a 0,4 por cento (Calen/CHX), por 7, 21 e 63 dias, respectivamente; Grupos IV, V e VI (n=10) - pasta UltraCal™ associada à CHX a 2 por cento (pasta experimental fornecida pela Ultradent Products Inc.; Ultracal/CHX), por 7, 21 e 63 dias, respectivamente; e Grupos VII e VIII (n=5) - tubo de polietileno vazio, por 7 e 21 dias, respectivamente. Decorridos os períodos experimentais, os implantes foram removidos juntamente com os tecidos circundantes (pele e tecido conjuntivo). Os tecidos foram submetidos ao processamento histotécnico de rotina, para análise histopatológica. Empregando um sistema de escores, os seguintes critérios foram considerados para a análise qualitativa e quantitativa: fibrosamento, espessura tecidual e infiltrado inflamatório. Foi efetuada, também, a análise quantitativa da medida da espessura (µm), área (µm²) e perímetro (µm) do tecido granulomatoso reacional formado na abertura dos tubos. Os dados obtidos foram submetidos à análise estatística, empregando o teste de Kruskal-Wallis e o pós-teste de Dunn. O nível de significância adotado foi de 5 por cento. Os resultados demonstraram biocompatibilidade da pasta Calen associada à CHX a 0,4 por cento com o tecido adjacente, com fibrosamento discreto, assim como tecido conjuntivo normal, sem diferença estatística significante com os controles (p>0,05). Nos Grupos I, II e III houve predominância do escore 1, enquanto que nos Grupos IV, V e VI houve predominância dos escores 2 e 3, em todos os parâmetros analisados. Em relação ...

Antibacterial activity of root canal filling materials for primary teeth: zinc oxide and eugenol cement, Calen paste thickened with zinc oxide, Sealapex and EndoREZ

This study evaluated in vitro the antibacterial activity of 4 root canal filling materials for primary teeth - zinc oxide and eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO), Sealapex sealer and EndoREZ sealer - against 5 bacterial strains commonly found in endodontic infections (Kocuria rhizophila, Enterococcus faecalis, Streptococcus mutans, Escherichia coli and Staphylococcus aureus) using the agar diffusion test (agar-well technique). Calen paste, 1 percent chlorhexidine digluconate (CHX) and distilled water served as controls. Seven wells per dish were made at equidistant points and immediately filled with the test and control materials. After incubation of the plates at 37oC for 24 h, the diameter of the zones of bacterial growth inhibition produced around the wells was measured (in mm) with a digital caliper under reflected light. Data were analyzed statistically by analysis of variance and Tukey's post-hoc test (?=0.05). There were statistically significant differences (p<0.0001) among the zones of bacterial growth inhibition produced by the different materials against all target microorganisms. K. rhizophila was inhibited more effectively (p<0.05) by ZOE, while Calen/ZO had its highest antibacterial activity against E. faecalis (p<0.05). S. mutans was inhibited by Calen/ZO, Sealapex and ZOE in the same intensity (p>0.05). E. coli was inhibited more effectively (p<0.05) by ZOE, followed by Calen/ZO and Sealapex. Calen/ZO and ZOE were equally effective (p>0.05) against S. aureus, while Sealapex had the lowest antibacterial efficacy (p<0.05) against this microorganism. EndoREZ presented antibacterial activity only against K. rhizophila and S. aureus. The Calen paste and Calen/ZO produced larger zones of inhibition than 1 percent CHX when the marker microorganism was E faecalis. In conclusion, the in vitro antibacterial activity of the 4 root canal filling materials for primary teeth against bacterial strains...

Este estudo avaliou in vitro a atividade antibacteriana de 4 materiais obturadores de canais radiculares de dentes decíduos - cimento de óxido de zinco e eugenol (OZE), pasta Calen espessada com óxido de zinco (Calen/OZ), cimento Sealapex e cimento EndoREZ - sobre 5 cepas bacterianas comumente encontradas em infecções endodônticas: Kocuria rhizophila, Enterococcus faecalis, Streptococcus mutans, Escherichia coli e Staphylococcus aureus, usando o teste de difusão em ágar (técnica do poço). A pasta Calen, digluconato de clorexidina a 1 por cento (CHX) e água destilada foram usados como controle. Sete poços por placa foram preparados em pontos eqüidistantes e imediatamente preenchidos com os materiais experimentais e controle. Após incubação das placas a 37oC por 24 h, o diâmetro dos halos de inibição do crescimento bacteriano formados ao redor dos poços foi medido (em mm) com um paquímetro digital sob luz refletida. Os dados obtidos foram submetidos à análise de variância e ao pós-teste de Tukey (?=0,05). Com relação à atividade antibacteriana, evidenciaram-se diferenças estatisticamente significantes (p<0,0001) entre os halos de inibição formados pelos diferentes materiais, para todos os microrganismos avaliados. A K. rhizophila foi inibida mais eficazmente pelo OZE (p<0,05), enquanto que o E. faecalis foi inibido mais eficazmente pela Calen/OZ (p<0,05). O S. mutans foi inibido pela Calen/OZ, cimento Sealapex e OZE na mesma intensidade (p>0,05). A E. coli foi inibida mais eficazmente pelo OZE, seguido pela Calen/OZ e pelo cimento Sealapex (p<0,05). O S. aureus foi inibido pela Calen/OZ e OZE na mesma intensidade (p>0,05), e menos intensamente pelo cimento Sealapex (p<0,05). O cimento EndoREZ apresentou atividade antibacteriana apenas frente a K. rhizophila e ao S. aureus. A pasta Calen e a Calen/OZ ocasionaram halos de inibição maiores que a CHX quando o microrganismo indicador foi o E. faecalis. Pode-se concluir que a atividade antibacteriana...

Arrest of root formation in a permanent maxillary central incisor subsequent to trauma and pulp necrosis to the primary predecessor.

This paper reports a case in which a previous traumatic injury at the age of 2 and pulp necrosis to a primary incisor resulted in a rare injury to the permanent successor tooth. The radiographic examination at the age of 9 showed the arrest of root formation of the permanent maxillary right central incisor, which did not erupt. Tooth 11 was extracted and a functional removable space maintainer was prepared. At the age of 17, the patient received an anterior fixed prosthesis for re-establishment of the esthetics, phonetics and deglutition.

Vertical alveolar crest bone maintenance around implants in two-stage surgery: an in situ study in dogs.

The aim of this study was to evaluate in situ changes in the alveolar crest bone height around immediate implant-supported crowns in comparison to tooth-supported crowns (control) with the cervical margins located at the bone crest level, without occlusal load. In Group I, after extraction of 12 mandibular premolars from 4 adult dogs, implants from Branemark System (MK III TiU RP 4.0 x 11.5 mm) were placed to retain complete acrylic crowns. In Group II, premolars were prepared to receive complete metal crowns. Sixteen weeks after placement of the crowns (38 weeks after tooth extraction), the height of the alveolar bone crest was measured with a digital caliper. Data were analyzed statistically by the Mann-Whitney test at 5% significance level. The in situ analysis showed no statistically significant difference (p=0.880) between the implant-supported and the tooth-supported groups (1.528 + 0.459 mm and 1.570 + 0.263 mm, respectively). Based on the findings of the present study, it may be concluded that initial peri-implant bone loss may result from the remodeling process necessary to establish the biological space, similar to which occurs with tooth-supported crowns.

Radiographic evaluation of pulpal and periapical response of dogs' teeth after pulpotomy and use of recombinant human bone morphogenetic protein-7 as a capping agent.

PURPOSE: The purpose of this study was to evaluate radiographically the pulpal and periapical response of dogs' teeth after pulpotomy and the use of recombinant human bone morphogenetic protein-7 (rHuBMP-7). METHODS: Pulpotomies were performed in 60 teeth of 6 dogs, and the remaining radicular pulp tissue was capped with the following materials: (a) groups 1 and 5-recombinant human bone morphogenetic protein-7 associated with recombinant human-like collagen; (b) groups 2 and 6-recombinant human-like collagen; (c) groups 3 and 7-calcium hydroxide; and (d) groups 4 and 8-zinc oxide and eugenol cement. After 7 days (groups 1-4) and 70 days (groups 5-8), standardized periapical radiographs were taken and the integrity of the lamina dura, presence of areas of periapical bone rarefaction, internal/external root resorption, and dentin bridge formation were evaluated. The results were analyzed statistically by Fisher's exact test and Bonferroni correction. The radiolucent areas suggestive of periapical lesions associated with the roots were measured in mm2, and the results were compared by Kruskal-Wallis test. RESULTS: In the 7-day period, all specimens in groups 1 to 4 presented intact lamina dura and absence of periapical bone rarefaction, internal/external root resorption or dentin bridge formation. In the 70-day period, no specimen in groups 5, 6, and 8 presented dentin bridge formation. Periapical bone rarefaction areas were observed to be associated with 100%, 60%, and 40% of the roots in group 6, 8, and 5, respectively. The largest lesions were found in group 6, followed by groups 5 and 8 (P<.05). In group 7, there was dentin bridge formation in 60% of the cases and intact lamina dura and no periapical bone rarefaction in all specimens. CONCLUSION: The use of rHuBMP-7/rHuCollagen as a capping material after pulpotomy did not induce mineralized tissue deposition, leading to the formation of radiographically visible periapical lesions.

Vertical alveolar crest bone maintenance around implants in two-stage surgery: an in situ study in dogs

The aim of this study was to evaluate in situ changes in the alveolar crest bone height around immediate implant-supported crowns in comparison to tooth-supported crowns (control) with the cervical margins located at the bone crest level, without occlusal load. In Group I, after extraction of 12 mandibular premolars from 4 adult dogs, implants from Branemark System (MK III TiU RP 4.0 x 11.5 mm) were placed to retain complete acrylic crowns. In Group II, premolars were prepared to receive complete metal crowns. Sixteen weeks after placement of the crowns (38 weeks after tooth extraction), the height of the alveolar bone crest was measured with a digital caliper. Data were analyzed statistically by the Mann-Whitney test at 5 percent significance level. The in situ analysis showed no statistically significant difference (p=0.880) between the implant-supported and the tooth-supported groups (1.528 + 0.459 mm and 1.570 + 0.263 mm, respectively). Based on the findings of the present study, it may be concluded that initial peri-implant bone loss may result from the remodeling process necessary to establish the biological space, similar to which occurs with tooth-supported crowns.

O objetivo do presente estudo foi comparar in situ modificações ocorridas na crista óssea alveolar induzidas por implantes imediatos e às induzidas por dentes naturais, ambos preparados para suportarem dispositivos protéticos situados sobre a margem óssea cervical, sem carga oclusal. No grupo I, após a extração de 12 pré-molares inferiores de 4 cães adultos, foram instalados implantes do Sistema Branemark (MK III TiU RP 4,0 x 11,5 mm) e coroas totais acrílicas. No grupo II, os pré-molares, foram submetidos a preparos convencionais, sendo cimentadas coroas totais metálicas. Após 16 semanas da instalação das coroas (38 semanas após a extração), a reabsorção da crista óssea alveolar foi avaliada in situ, por meio da mensuração das peças, com paquímetro digital. Para obtenção das medidas do grupo I, os pontos de referência foram a plataforma de assentamento do implante e a crista óssea alveolar. No grupo II, a posição do limite cervical da prótese e o início da crista óssea. Os valores obtidos foram comparados pelo teste de Mann-Whitmey com nível de significância de 5 por cento. A média de reabsorção da crista óssea foi de 1,528 + 0,459 mm para o grupo I e de 1,570 + 0,263 mm para o grupo II, não havendo diferença estatisticamente significante (p=0,880) entre os grupos. Os resultados do presente estudo permitiram concluir que a reabsorção perimplantar inicial que ocorre na crista óssea resulta de um padrão de remodelação necessário para o estabelecimento do espaço biológico na área, assim como ocorre nos dentes naturais preparados para receberem próteses convencionais.

Scanning electron microscopy of the apical structure of human teeth.

The objective of this research was to evaluate, by scanning electron microscopy, the apical structure of extracted human permanent teeth with different degrees of pulp and periapical pathology. A total of 25 teeth were extracted: 5 teeth with vital pulp (group I); 10 teeth with pulp necrosis without radiographically visible periapical lesion (group II); 10 teeth with pulp necrosis with radiographically visible periapical lesion (group III). The root apex was sectioned and processed for scanning electron microscopy. In groups I and II, fibers covered the root cementum and there was no cementum resorption or microorganisms. There were areas of cementum resorption in group III with microorganisms on the root apex surface (biofilm) and no fibers. The authors conclude that the presence of chronic periapical lesions causes severe changes in the apical structure with a destruction of fibers and different degrees of cementum resorption forming lacunae in which bacterial biofilm persisted.

Aggressive periodontitis associated with Papillon-Lefèvre syndrome: report of a 14-year follow-up.

This case report describes the periodontal management, therapeutic approach, and 14-year follow-up of a patient diagnosed with Papillon-Lefevre syndrome (PLS). A female child, diagnosed with PLS-associated periodontitis at the age of 9 years and 11 months, presented with hyperkeratosis of the palms and soles, as well as generalized aggressive periodontitis. The dental treatment comprised standard periodontal debridement, scaling and root planing, instructions on oral hygiene, restorations, extraction of hopelessly affected teeth and a therapeutic use of antibiotics. The concomitant supportive periodontal therapy and antibiotic coverage could not stop the loss of periodontal attachment and destruction of the alveolar bone. Four years after treatment was initiated, the last remaining teeth were extracted and complete dentures were constructed. The dentures have been periodically replaced and the patient continues to return for follow-up once a year. The combination of intensive periodontal treatment and antibiotic regimen only temporarily delayed periodontal disease progression and did not prevent loss of both primary and permanent teeth. The outcome of this long-term follow-up case report shows that management of PLS-associated periodontitis is further complicated when the patient is first seen in the mixed dentition stage or later. In these situations, the chances of controlling the progression of periodontal breakdown and minimizing tooth loss are greatly reduced.

Biological restorations as a treatment option for primary molars with extensive coronal destruction--report of two cases.

This article reports the cases of two young children aged 4 and 5 years, in whom biological restorations using tooth fragments were placed in primary molars with severely damaged crowns due to extensive carious lesions. After radiographic and clinical evaluation, tooth fragments obtained from extracted teeth in stock were autoclaved, adjusted to the prepared cavity and bonded to the remaining tooth structure with either adhesive system (Case 1) or dual-cure resin-based cement (Case 2) over a calcium hydroxide layer and a glass ionomer cement base. Occlusal adjustment was performed and topical sodium fluoride was applied to tooth surface. Periodical clinical and radiographic controls were carried out and the restored teeth were followed up for 4 and 3 years, respectively, until exfoliation. In these two reports, the technical aspects are described and the benefits and disadvantages of biological restorations as an alternative treatment for rehabilitation of severely destroyed primary molars are discussed.

Pulpal and periapical response of dogs' teeth after pulpotomy and use of recombinant human bone morphogenetic protein-7 as a capping agent.

OBJECTIVE: The purpose of this study was to evaluate the pulpal and periapical response of dogs' teeth after pulpotomy and the use of recombinant human bone morphogenetic protein-7 as a capping agent. METHODS: Pulpotomy was performed in 60 teeth from 6 dogs, and the remaining pulp tissue was capped with the following materials: (a) groups 1 and 5: recombinant human bone morphogenetic protein-7 associated with recombinant human-like collagen; (b) groups 2 and 6: recombinant human-like collagen; (c) groups 3 and 7: calcium hydroxide; and (d) groups 4 and 8: zinc oxide and eugenol cement. After 7 days (groups 1-4) and 70 days (groups 5-8), the animals were sacrificed and the pieces containing the teeth were removed and processed for histological analysis. RESULTS: Seven-day period: according to the type of inflammatory infiltrate observed in the root pulp tissue: (a) groups 1 and 2 were classified as severe with intense vascular proliferation; (b) group 4 was classified as moderate; and (c) group 3 was classified as mild. No dentin bridge formation was observed in any specimen, and the periapical region had normal appearance. 70-day period: groups 5, 6, and 8 showed no dentin bridge formation, and the remaining pulp tissue presented necrotic areas with inflammatory cells in the periapical region as well as bone and cemental resorption. In group 7, there was dentin bridge formation, absence of inflammation, and absence of mineralized tissue resorption. CONCLUSION: The use of rHuBMP-7/rHuCollagen as a capping material after pulpotomy did not show either satisfactory apical and periapical response or capacity of inducing deposition of mineralized tissue.